“It’s Like I’m Living Inside a Dead Zone: Reporting on the Hidden Lives of the Uninsured”

Inara Verzemnieks wrote the New York Times Magazine feature “Life in Obamacare’s Dead Zone,” an in-depth look at the physical and psychological toll of poor Americans excluded from the Affordable Care Act.

Excerpt:

It would seem that lower-income Americans are among the greatest beneficiaries of the A.C.A.’s reforms. And yet in some states this same population also remains, paradoxically, among the reforms’ greatest losers. This subpopulation is living inside a kind of “dead zone,” as Foy put it to me one day, searching for the right metaphor to describe her predicament. A long and suspended silence, she called it, “like when you can’t receive a single call, a single text.”

How these dead zones formed is a matter of unanticipated consequences. The A.C.A.’s architects did not predict that the Supreme Court would rule in 2012 that it was up to each state whether to expand Medicaid eligibility, which is how they imagined Americans with the most modest incomes would receive coverage. Even though the federal government would have helped fund the expansion, 19 states opted for ideological reasons not to do so, arguing that they are pushing back against government bloat and the fostering of dependency. A result was that the residents with the lowest incomes in those 19 states were now caught between two nonoptions: They made too much to qualify for Medicaid, or didn’t qualify at all, but they also made too little for publicly subsidized insurance on the exchanges, their income not high enough to trigger the refundable tax credits and cost-sharing that could make the possibility remotely affordable to someone making just a few dollars above the federal poverty level.

This paradox is referred to widely as the coverage gap.

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Verzemnieks’s essays and journalism have appeared in such publications as The New York Times Magazine, Tin House, The Atlantic, The Iowa Review, and Creative Nonfiction. A Pushcart Prize winner and the recipient of a Rona Jaffe Writer’s Award, as well as a finalist for the Pulitzer Prize in feature writing, she previously worked as a newspaper journalist for thirteen years.

She is especially interested in stories that cannot be accessed unless the writer is on the ground, fully immersed in the lives she is trying to understand – stories that demand that we stay and inhabit a place until we move past seeing it simply as spectacle.